临床误诊误治2026，Vol.39Issue(11)：19-24,6.DOI:10.3969/j.issn.1002-3429.2026.11.004
新生儿MN血型不合溶血病致极重度贫血误诊分析并文献回顾
Misdiagnosis of extremely severe anemia caused by MN blood group incompatibility hemolytic disease of the newborn and literature review
摘要
Abstract
Objective To investigate the clinical characteristics,misdiagnosis causes and prevention strategies of extremely severe anemia caused by MN blood group incompatibility hemolytic disease of the newborn.Methods The clinical data of 1 neonate with extremely severe anemia as the initial manifestation,who was misdiagnosed as MN blood group incompatibility hemolytic disease and admitted to Maternal and Child Health Hospital of Jinniu District,Chengdu City,in July 2022,were retrospectively analyzed.Results The neonate was admitted to the hospital due to severe skin pallor and dyspnea immediately after birth,and was initially diagnosed as extremely severe anemia of the newborn;however,the underlying etiology remained unclear.Laboratory tests revealed a hemoglobin level of 41 g/L,a reticulocyte ratio of 0.116,indirect bilirubin accounting for 83.3%of total bilirubin,a plasma free hemoglobin of 386 mg/L,and a haptoglobin below the detectable range,which was consistent with the manifestation of acute intravascular hemolysis.After initially excluding ABO and Rh blood group incompatibility hemolytic diseases,further blood group serological testing showed that the neonate's MN blood group was M(+)N(+),while the mother's MN blood group was NN type M(-)N(+)with a positive anti-M antibody(titer 1∶16).Therefore,a diagnosis of MN blood group incompatibility hemolytic disease was confirmed.The misdiagnosis lasted 40 h.After confirmation,the anemia was quickly corrected by transfusion of M antigen-negative red blood cell suspension,and combined with comprehensive treatments such as blue light phototherapy,immunoglobulin and invasive ventilator-assisted ventilation,the neonate recovered well and was discharged smoothly after 14 days of hospitalization.During 2 months of follow-up,the neonate's serum total bilirubin was normal,vital signs were stable,and growth and development were comparable to those of peers.Conclusion Although MN blood group incompatibility hemolytic disease of the newborn is rare,it can cause extremely severe anemia,with non-specific clinical manifestations,which is prone to misdiagnosis.For neonates with severe anemia after excluding common hemolytic diseases,maternal and neonatal MN blood group and anti-M antibody detection should be performed as early as possible to avoid misdiagnosis and mistreatment.关键词
新生儿溶血病/MN血型不合/误诊/极重度贫血/抗M抗体Key words
hemolytic disease of the newborn/MN blood group incompatibility/misdiagnosis/extremely severe anemia/anti-M antibody引用本文复制引用
谈丽菊,娄小燕,吴迪,何柳..新生儿MN血型不合溶血病致极重度贫血误诊分析并文献回顾[J].临床误诊误治,2026,39(11):19-24,6.基金项目
四川省妇幼医学科技创新课题重点项目(2020ZD07) （2020ZD07）
成都市医学科研课题立项项目(2020173) （2020173）
